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Related Experiment Videos

Radiological investigation in acute diverticulitis

R F McKee1, R W Deignan, Z H Krukowski

  • 1Department of Surgery, Aberdeen Royal Infirmary, Foresterhill, UK.

The British Journal of Surgery
|May 1, 1993
PubMed
Summary

Radiological imaging aids in assessing acute sigmoid diverticulitis severity. Water-soluble contrast enema is a safe, available, and effective early investigation for management decisions.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Management

Background:

  • Acute sigmoid diverticulitis management relies on assessing inflammatory severity.
  • Radiological investigation is an underutilized tool for clinical assessment.

Purpose of the Study:

  • To evaluate the utility of various radiological investigations in diagnosing and managing acute sigmoid diverticulitis.
  • To determine the most effective early supplementary investigation for acute diverticulitis.

Main Methods:

  • Review of plain abdominal radiography, contrast enema (water-soluble and barium), ultrasonography, computed tomography (CT), radionuclide scans, and magnetic resonance imaging.
  • Comparison of diagnostic accuracy and safety profiles of different imaging modalities.

Main Results:

  • Plain radiography shows non-specific abnormalities in 30-50% of patients.
  • Water-soluble contrast enema provides sufficient information for management decisions and is safer than barium in suspected perforation.
  • CT and ultrasonography are useful for abscess visualization and guiding aspiration.
  • CT is not more specific than contrast enema for diagnosing acute diverticulitis.
  • Radionuclide scans and MRI have limited roles in routine assessment.

Conclusions:

  • Water-soluble contrast enema is a safe, widely available, and highly useful early investigation for acute sigmoid diverticulitis.
  • Radiological assessment, particularly with contrast enema, is crucial for optimal management decisions.

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